Provider Demographics
NPI:1710746581
Name:LUNDIN, CHRISTIAN (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:LUNDIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14034 N KENDALL DR APT B
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-2885
Mailing Address - Country:US
Mailing Address - Phone:602-737-7425
Mailing Address - Fax:
Practice Address - Street 1:3200 N DOBSON RD STE D-3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-9610
Practice Address - Country:US
Practice Address - Phone:602-737-7425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health